论文部分内容阅读
目的 探讨盐酸拓扑替康 (TPT)在治疗小细胞肺癌中的临床疗效和不良反应。方法 36例小细胞肺癌患者接受TPT治疗。分二组。A组 32例 ,TPT 1.2mg/m2 ,静脉滴注 30min ,连用 5d(第 1～ 5天 ) ,2 1d为 1周期 ,连用 2周期 ;B组 4例 ,TPT用法同前 ,联合顺铂 6 0mg/m2 ,第 1天静脉滴注 ,水化 3d ,2 1d为 1周期 ,连用 2周期。结果 可评价疗效 30例 ,其中A组 2 6例 ,B组 4例。总有效率A组 4 6 .2 % ,B组 2 5 .0 %。中位生存期A组4 8.2周 ,B组 2 6周。 1年生存率A组初治 5 8.8% ,复治 4 2 .8% (B组例数少无法评价 )。可评价不良反应 36例 ,主要有骨髓抑制 (Ⅲ、Ⅳ度中性粒细胞下降 ,血小板降低 )、恶心、呕吐、腹泻、脱发、乏力等 ,对心、肝、肾功能均无影响。结论 TPT是对小细胞肺癌有较好治疗作用的药物 ,剂量限制性毒性为骨髓抑制。前景为继续探讨在小细胞肺癌治疗中适宜的剂量和联合使用其他抗肿瘤药物的有效剂量 ,并进一步减轻不良反应 ;探讨TPT在非小细胞肺癌中的治疗作用、适宜的剂量、疗效及不良反应
Objective To investigate the clinical efficacy and adverse reactions of topotecan hydrochloride (TPT) in the treatment of small cell lung cancer. Methods Thirty-six patients with small cell lung cancer underwent TPT. Divided into two groups. A group of 32 patients, TPT 1.2mg / m2, intravenous infusion of 30min, continuous use 5d (days 1 to 5 days), 21 days for a cycle, once every 2 cycles; B group 4 cases, TPT usage with the former, combined with cisplatin 6 0mg / m2, the first day of intravenous infusion, hydration 3d, 2d for 1 cycle, once every 2 cycles. Results The curative effect was evaluated in 30 cases, including 26 cases in group A and 4 cases in group B. The total effective rate was 46.2% in group A and 25.0% in group B. The median survival time in group A was 4 8.2 weeks, while in group B 26 weeks. The 1-year survival rate was 5 8.8% in group A and 42.8% in group A (the number of patients in group B was less than that in group B). There were 36 patients with adverse reactions, including myelosuppression (Ⅲ, Ⅳ neutropenia, thrombocytopenia), nausea, vomiting, diarrhea, hair loss, fatigue and so on, had no effect on heart, liver and kidney function. Conclusion TPT is a good therapeutic agent for small cell lung cancer. The dose-limiting toxicity is myelosuppression. Prospects to continue to explore the appropriate dose in the treatment of small cell lung cancer and the combined use of other anti-tumor drugs effective dose, and further reduce adverse reactions; explore TPT in non-small cell lung cancer in the role of treatment, the appropriate dose, efficacy and adverse reactions